A retrospective study of risk factors for severe acute respiratory syndrome coronavirus 2 infections in hospitalized adult patients.

Abstract

Coronavirus disease 2019 (COVID‑19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection spread worldwide. The aim of the study was to identify the clinical characteristics and risk factors associated with severe incidence of SARS ‑CoV‑2 infection. All adult patients (median [IQR] age, 52 [37-58] years) consecutively admitted to the Dabieshan Medical Center from January 30, 2020 to February 11, 2020 were collected and reviewed. Only patients diagnosed with COVID‑19 according to the World Health Organization interim guidance were included in this retrospective cohort study. A total of 108 patients with COVID‑19 were retrospectively analyzed. Twenty‑five patients (23.1%) developed severe disease, and of those 12 patients (48%) died. Advanced age, comorbidities (most commonly hypertension), higher blood leukocyte count, neutrophil count, higher C‑reactive protein level, D‑dimer level, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score were associated with greater risk of COVID‑19, and so were lower lymphocyte count and albumin level. Multivariable regress ion showed increasing odds of severe COVID‑19 associated with higher SOFA score (odds ratio [OR], 2.45; 95% CI, 1.302-4.608; P = 0.005), and lymphocyte count less than 0.8 × 109/l (OR, 9.017; 95% CI, 2.808-28.857; P <0.001) on admission. Higher SOFA score (OR, 2.402; 95% CI, 1.313-4.395; P = 0.004) on admission was identified as risk factor for in‑hospital death. Lymphocytopenia and a higher SOFA score on admission could help clinicians to identify patients at high risk for developing severe COVID‑19. More related studies are needed in the future.